Wen Jian, Zhou Gao, Bin Yong, Zeng Yan, Tan Dianxiang, Zhang Juan
Department of Anesthesiology, Hengyang Central Hospital, No. 12, Yancheng Road, Yanfeng District, Hengyang, 421001, Hunan, China.
Department of Gastrointestinal Surgery, Hengyang Central Hospital, Hengyang, 421001, Hunan, China.
Discov Oncol. 2025 Jun 11;16(1):1053. doi: 10.1007/s12672-025-02762-2.
We aim to evaluate the analgesic efficacy of ultrasound-guided thoracic paravertebral nerve block (TPVB) using ropivacaine combined with esketamine in lung cancer patients undergoing thoracoscopic radical surgery.
This retrospective study included clinical data from 74 lung cancer patients who underwent thoracoscopic radical surgery between January 2023 and June 2024. Patients were divided into two groups based on their analgesic regimen: the control group received standard general anesthesia, while the observation group received ultrasound-guided TPVB with ropivacaine combined with esketamine. General clinical parameters, changes in mean arterial pressure (MAP) and heart rate (HR), postoperative pain scores, serum pain mediator levels, time to awakening, time to mobilization, and duration of hospitalization, and incidence of adverse reactions were compared in two groups.
There were no significant differences between the two groups in terms of operation time, intraoperative bleeding, or dosages of sufentanil and remifentanil. Compared to the control group, the observation group showed lower MAP and HR at the completion of the operation. Additionally, Visual Analog Scale scores and serum levels of Neuropeptide Y, Substance P, and dopamine were also lower in the observation group. The postoperative time to awakening, time to mobilization, and duration of hospitalization were shorter in the observation group. No significant differences were observed in the incidence of adverse reactions between the two groups.
Ultrasound-guided TPVB with ropivacaine and esketamine provides superior postoperative analgesia in lung cancer patients undergoing thoracoscopic radical surgery. This approach effectively reduces physiological stress responses, promotes faster recovery, and does not increase the risk of adverse events.
我们旨在评估在接受胸腔镜根治性手术的肺癌患者中，使用罗哌卡因联合艾司氯胺酮进行超声引导下胸椎旁神经阻滞（TPVB）的镇痛效果。
这项回顾性研究纳入了2023年1月至2024年6月期间接受胸腔镜根治性手术的74例肺癌患者的临床资料。根据镇痛方案将患者分为两组：对照组接受标准全身麻醉，而观察组接受超声引导下罗哌卡因联合艾司氯胺酮的TPVB。比较两组的一般临床参数、平均动脉压（MAP）和心率（HR）变化、术后疼痛评分、血清疼痛介质水平、苏醒时间、活动时间、住院时间以及不良反应发生率。
两组在手术时间、术中出血量或舒芬太尼和瑞芬太尼用量方面无显著差异。与对照组相比，观察组在手术结束时MAP和HR较低。此外，观察组的视觉模拟评分以及神经肽Y、P物质和多巴胺的血清水平也较低。观察组术后苏醒时间、活动时间和住院时间较短。两组不良反应发生率无显著差异。
在接受胸腔镜根治性手术的肺癌患者中，超声引导下罗哌卡因联合艾司氯胺酮的TPVB提供了更好的术后镇痛效果。这种方法有效降低了生理应激反应，促进了更快的恢复，且不会增加不良事件的风险。
